Perri F, Clemente R, Festa V, Quitadamo M, Conoscitore P, Niro G, Ghoos Y, Rutgeerts P, Andriulli A
Divisione di Gastroenterologia, Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
Ital J Gastroenterol Hepatol. 1998 Apr;30(2):146-50.
This study was carried out to evaluate whether the 13C-urea breath test could assess the intragastric Helicobacter pylori load and predict the outcome of infected subjects undergoing short-term triple therapy.
A total of 108 infected patients underwent upper endoscopy with antral biopsies and histological grading of Helicobacter pylori density. These patients received omeprazole 20 mg b.i.d., clarithromycin 500 mg b.i.d., and amoxycillin 1000 mg b.i.d. or tinidazole 500 mg b.i.d. for one week. 13C-urea breath test (75 mg 13C-urea; results expressed as Delta Over Baseline values at 30') was performed before and after therapy. According to pre-treatment Delta Over Baseline at 30' values, patients were assigned to low (< 16/1000), intermediate (16-35/1000) and high (> 35/1000) Delta Over Baseline at 30' groups.
A significant correlation was found between pre-treatment Delta Over Baseline at 30' values and the density of Helicobacter pylori (rs = 0.76). The eradication rates were 82%, 67%, and 17% in the low, intermediate, and high Delta Over Baseline at 30' groups, respectively (p = 0.0001). When classified according to the outcome of therapy, the median pre-treatment Delta Over Baseline at 30' value was 15.7 in eradicated subjects vs 21.6 in non eradicated patients (p = 0.002). In patients who failed eradication, a significant difference was also observed between pre- and post-treatment Delta Over Baseline at 30' values (21.6 vs 15.6, p = 0.019).
The 13C-urea breath test can be used to evaluate the intragastric bacterial load and to predict the outcome of standard eradication treatment.
本研究旨在评估¹³C尿素呼气试验能否评估胃内幽门螺杆菌负荷，并预测接受短期三联疗法的感染患者的治疗结果。
共有108例感染患者接受了上消化道内镜检查及胃窦活检，并对幽门螺杆菌密度进行了组织学分级。这些患者接受奥美拉唑20mg，每日两次，克拉霉素500mg，每日两次，阿莫西林1000mg，每日两次或替硝唑500mg，每日两次，疗程为一周。在治疗前后进行¹³C尿素呼气试验（75mg¹³C尿素；结果以30分钟时的Δ超过基线值表示）。根据治疗前30分钟时的Δ超过基线值，将患者分为低（<16/1000）、中（16 - 35/1000）和高（>35/1000）Δ超过基线值30分钟组。
治疗前30分钟时的Δ超过基线值与幽门螺杆菌密度之间存在显著相关性（rs = 0.76）。低、中、高Δ超过基线值30分钟组的根除率分别为82%、67%和17%（p = 0.0001）。根据治疗结果分类，根除患者治疗前30分钟时的Δ超过基线值中位数为15.7，未根除患者为21.6（p = 0.002）。在根除失败的患者中，治疗前和治疗后30分钟时的Δ超过基线值也存在显著差异（21.6对15.6，p = 0.019）。
¹³C尿素呼气试验可用于评估胃内细菌负荷，并预测标准根除治疗的结果。
